The diagnostic challenge of pandemic H1N1 2009 virus in a dengue-endemic region: A case report of combined infection in Jeddah, Kingdom of Saudi Arabia

SummaryIt is difficult to distinguish dengue fever from other febrile illnesses in a dengue-endemic area. This issue was compounded during the H1N1 2009 pandemic of influenza, which also presents as a febrile illness. This first laboratory-confirmed case of co-infection with dengue and influenza A H1N1 2009 strain in Jeddah, Saudi Arabia, highlights the importance of considering co-infections because not only is influenza an ongoing concern in Jeddah, but several viral hemorrhagic fever viruses circulate in this region.

► Combined infection of dengue and Influenza A H1N1 2009 from Jeddah, Saudi Arabia is reported. ► Both presented as febrile illness with non specific symptoms. ► Co-existence of both viruses was confirmed by PCR. ► Influenza A H1N1 2009 strain was wild-type not carrying H275Y Oseltamivir resistance. ► Co-existence of influenza with viral hemorrhagic fevers should be considered in endemic ares.